The Middle Paleolithic is the second period in the Paleolithic or Old Stone Age. There are considerable dating differences between regions. The period was preceded by the Lower Paleolithic and succeeded by the Upper Paleolithic. This period is when archaic humans including Homo sapiens neanderthalensis appeared and flourished all over the world. According to the theory of the African origin of modern humans, anatomically modern humans began migrating out of Africa about 125.000 years BC and began to replace earlier pre-existing Homo species such as the Neanderthals and Homo erectus.

It is the Neanderthal era. Hand axes continued in use, but a new kind of stone tool kit called the Mousterian (called after the French site) was created, which included purposefully prepared cores and specialized flake tools. Both Homo sapiens and Neanderthals included scavenging as living method. There is also clear evidence of hunting and gathering activities, as are found at a handful of sites, e.g., La Ferassie and Shanidar Cave. About 55.000 BC, archaic humans were tending for their elderly, as evidenced at site La Chapelle aux Saintes. There are also places found with evidence for cannibalism amongst them.

The Middle Paleolithic ends with the gradual disappearance of the Neanderthal and the ascendancy of Homo sapiens sapiens. That did not happen in one night. The beginnings of modern human behaviors are mapped out in southern Africa, beginning about 77.000 years BC, and leaving Africa. The dates for the change to the Upper Paleolithic are a subject of discussion, as new sites are being found.

Neanderthals hung on after 50.000 BC. The latest known Neanderthal site in 2021 is Gorham’s Cave in Gibraltar. There is also the debate about the Flores individuals. These date to the Middle Paleolithic but extend well into the Upper Paleolithic, who may represent the separate species Homo floresciensis.